CAJ | 학술논문

目的：探讨香菇多糖联合XELOX方案治疗晚期结肠癌的效果，以及香菇多糖在结肠癌治疗过程中的应用价值。方法将2008年1月~2009年12月浙江省肿瘤医院收治的124例晚期结肠癌患者分为两组，治疗组63例患者采用XELOX方案化疗的同时给予香菇多糖，对照组61例仅采用XELOX方案化疗。在化疗过程中比较两组患者的不良反应、生活质量评定，全部病例在完成4个周期治疗后作疗效评价，同时检测患者的T细胞免疫功能。随访6~60个月，比较两组患者的无进展生存期和总生存期。结果两组均未发生治疗相关性死亡。两组不良反应以血液学毒性、消化道反应、神经毒性为主，治疗组骨髓抑制发生率为77.8%(49/63)，相比对照组的91.8%(56/61)显著性降低(P=0.030)；神经系统损害发生率分别为20.66%(13/63)和44.26%(27/61)，差异有统计学意义(P=0.005)。治疗组KPS评分有效率为82.5%(52/63)，而对照组有效率为41.0%(25/61)，差异有高度统计学意义(χ2=22.738，P<0.01)。化疗后治疗组的CD3、CD4和CD4/CD8均高于对照组。治疗组有效率为55.56%(35/63)，高于对照组的31.15%(19/61)(χ2=7.510，P=0.006)。治疗组和对照组的临床有效率分别为79.37%(50/63)和62.29%(38/61)(χ2=4.383，P=0.036)。两组无进展生存率和生存率比较差异均无统计学意义(P=0.316、0.634)。结论香菇多糖联合XELOX方案化疗可增强患者的细胞免疫功能，提高化疗疗效，减轻化疗所致的毒副作用，明显改善生活质量，但其是否可以改善肿瘤患者的远期生存，尚待进一步研究。
목적：탐토향고다당연합XELOX방안치료만기결장암적효과，이급향고다당재결장암치료과정중적응용개치。방법장2008년1월~2009년12월절강성종류의원수치적124례만기결장암환자분위량조，치료조63례환자채용XELOX방안화료적동시급여향고다당，대조조61례부채용XELOX방안화료。재화료과정중비교량조환자적불량반응、생활질량평정，전부병례재완성4개주기치료후작료효평개，동시검측환자적T세포면역공능。수방6~60개월，비교량조환자적무진전생존기화총생존기。결과량조균미발생치료상관성사망。량조불량반응이혈액학독성、소화도반응、신경독성위주，치료조골수억제발생솔위77.8%(49/63)，상비대조조적91.8%(56/61)현저성강저(P=0.030)；신경계통손해발생솔분별위20.66%(13/63)화44.26%(27/61)，차이유통계학의의(P=0.005)。치료조KPS평분유효솔위82.5%(52/63)，이대조조유효솔위41.0%(25/61)，차이유고도통계학의의(χ2=22.738，P<0.01)。화료후치료조적CD3、CD4화CD4/CD8균고우대조조。치료조유효솔위55.56%(35/63)，고우대조조적31.15%(19/61)(χ2=7.510，P=0.006)。치료조화대조조적림상유효솔분별위79.37%(50/63)화62.29%(38/61)(χ2=4.383，P=0.036)。량조무진전생존솔화생존솔비교차이균무통계학의의(P=0.316、0.634)。결론향고다당연합XELOX방안화료가증강환자적세포면역공능，제고화료료효，감경화료소치적독부작용，명현개선생활질량，단기시부가이개선종류환자적원기생존，상대진일보연구。
Objective To investigate the effect of Lentinan combined with XELOX in patients with advanced colon can-cer, to explore the value of Lentinan on treatment for colon cancer. Methods From January 2008 to December 2009 one hundred-four patients with advanced colon cancer in Zhejiang Cancer Hospital were divided into two groups. XELOX chemotherapy combined with Lentinan was administered to the treatment group (n=63), and the control group received XELOX chemotherapy only (n=61). Adverse reactions in the course of chemotherapy were compared, and quality of life was assessmented. All patients completed four cycles of therapy, then the efficacy was evaluated, T cell immune function in patients was detected. Followed up 6-60 months, progression-free survival (PFS) and overall sur-vival (OS) between two groups were compared. Results The treatment-related deaths did not occur in two groups. The common adverse reactions were hematologic toxicity, gastrointestinal toxicity, neurotoxicity in two groups. The occur-rence rate of bone marrow suppression was 77.8% (49/63) in treatment group, and 91.8% in control group, with a sig-nificant difference (P=0.030). The rate of nervous system damage was 20.66% (13/63) in treatment group and 44.26%(27/61) in control group, with a significant difference (P= 0.005). The rate of KPS score improved was 82.5% (52/63) in treatment group, and 41.0% (25/61) in control group, with a significant difference (χ2=22.738, P< 0.01). The short-term effect of patients in treatment group was better than that in control group (55.56% vs 31.15%, χ2=7.510, P =0.006). Clinical efficiency in treatment group was better than that in control group (79.37% vs 62.29%, χ2=4.383, P=0.036). The PFS and OS between two groups were not significantly different (P= 0.316, 0.634). Conclusion Lentinan combined XELOX regimen can enhance cellular immune function in patients with colon cancer, and improve the effi-cacy of chemotherapy, reduce the side effects caused by chemotherapy, and improve quality of life. But whether it can improve long-term survival in colon cancer must further study.